Study compares prosthetic levels, oxygen consumption in children with PFFD

CLEARWATER BEACH, Fla. – A speaker at the Association of Children’s Prosthetic-Orthotic Clinics Annual Meeting compared the impact different prosthetic levels have on children with proximal focal femoral deficiency.

Proximal focal femoral deficiency (PFFD) is a congenital deficiency of the femur, Kelly A. Jeans, MS, senior biomechanist at the Texas Scottish Rite Hospital for Children, said in her presentation. Patients with a stable hip, but a short femur may undergo a Syme amputation with the knee fused; patients with a normal ankle joint, of the affected limb, capable of 60° monition following rotation may undergo Vans Nes rotationplasty; and some patients may decline surgical management and use an equinus prosthesis to ambulate.

Kelly A. Jeans

“The purpose of the study was to determine the difference in metabolic cost between these groups,” Jeans said.

A total of 13 children with PFFD underwent oxygen consumption testing during overground walking, and were compared with a group of age and body mass index matched control subjects. Testing included a 5-minute rest period followed by a 10-minute walk at a self-selected speed. Variables included oxygen rate, heart rate, velocity and oxygen cost.

Researchers found no significant difference between patients walking with a Syme, Van Nes or Equinus prosthesis. The Syme and equinus groups maintained normal walking speed by increasing their oxygen rate, and each group had greater oxygen costs than the controls, findings showed.

“Although no significant differences were seen between PFFD subgroups, small sample size was likely a limitation,” Jeans said. “We are working to expand this in future trials.” – by Shawn M. Carter